Friday, 13 April 2012

Organ Donation - Do they deserve a second chance?

Do you believe that people who continuously abuse their bodies through excessive drinking, smoking, drugs, alcohol, over-eating and many other harmful behaviours should have an unfettered right to an organ transplant? And God forbid, should the first transplant fail, should they then be put on a waiting list to receive another organ?

This is where my aggravated annoyance kicks in. We only need visit a hospital to see just how many sick and dying people require donor transplants. Donors are hard to come by. Not everyone who dies donates their organs, so there is not an abundant amount of them available. It is then up to the specialists to decide who gets them first.

Should the donated kidney be given to Mr Obesity, who knew he was at critical point but refused to exercise, refused to eat a balanced healthy diet, and carefully sneaks a chocolate bar into the cupboard beside his hospital bed? Or should the kidney go to someone who would benefit more from it?

Should the donated lung go to Mrs Smoker, who can hardly breathe, barely able to walk, wearing a dressing gown, with one hand holding the stand of the hospital 'drip' whilst the other grasps a cigarette. She puffs away in the hospital gardens, fumigating all and sundry. I have seen this on many occasions and it saddens yet sickens me.

Most people will have heard of George Best, a famous footballer in England. He was an alcoholic who died in 2005. He had a liver transplant in 2002 via the National Health Service. In 2003 he was caught drinking again (not to mention his drunk driving episodes). George openly continued to drink before and after the transplant. It was like kicking sand in my face. Alcoholic cirrhosis is just one of the biggest reasons for requiring a liver transplant. The organ he received could have gone to someone more deserving.

With such a history, is there a possibility that he was deemed to fit the criteria because he was famous? Just one of my wild thoughts again.

What about all the thousands of others on the waiting list? Most of them will die waiting for a heart, kidney or liver. They chose to live a healthy life but found themselves in unfortunate situations, such as being diagnosed with an illness, having a severe accident or even the effects of medication through no fault of their own. Why weren't they shoved to the front of the queue?

Bloggers and guests:What is your honest opinion about donation of organs to people who have clearly abused their own bodies?Would you consider donating parts of your body after death or even donating your whole body to science?It would be great to hear your views.

I agree that there should be some basic criteria. There are some people who I do feel are more deservig than others. However, it does put us on a slippery slope. I'd hate to see a sliding scale of least to most deserving. Who would be the judge?

Medicine is an area of human endeavour in which people are forced to play God just in order to do their jobs. That's just the nature of the game.

Allow me to illustrate:

Money is limited. The treatment costs of many conditions would make your head spin.

If it costs 3 times as much to treat a cancer patient as someone suffering from heart disease, shouldn't the NHS just abandon cancer patients and focus on the area where more lives can be saved, cost efficiently?

How about terminal, incurable illnesses? Wouldn't it be better to spend money on people that have a chance and leave those with no hope to their fate?

Here in England the National Institute for Clinical Excellence (NICE) is the body of experts which decisions like this all day, every day. And they are constantly criticised for the decisions they make and held to a high level of accountability and transparency. Rightly so, since they spend public money.

So you see, sliding scales are an unavoidable part of commissioning health care and decisions like these are already being made. What RPD is suggesting here is that this sort of consideration also be extended to elegibilty for organ transplants, and that lifestyle factors should be included in the criteria. I agree.

JaneneYes, that's the thing. It's good to have a criteria but then again, I'm sure there will always be an ongoing argument of who is at the top and who is at the bottom. The specialists are the ones who always have the last say, and I guess it will always be hard for them to make those decisions. Thanks Janene.

Such criteria DOES exist (at least in my country) for the safety of the organ transplant. But there is no way to tell the intentions, or the future. I would be an organ donor if I could be. I have never worried about the worthiness of the donor. As for costs and, Organ donation and cost should not be uttered in the same breath, IMHO.But Alcholism, drug addiction, HIV and hepititis statuses are all issues that contribute to consideration for donation, along with non-compliance to other healthy living criteria. POST-transplant, well there is no way to limit those people, nor should there be.

Nice to see your smiling avatar again on RPD.Just a quick query (no offence ;) )... where was I? Oh yes...

When you say you don't have issues with worthiness I know what you mean. When I die even if the person who gets, say, my liver, is a raging alcoholic who drinks it into destruction all over again in the space of a few months, that's fine with me. I can't use it any more so even those few months he has are better than nothing.

But here's the rub- if he destroys my old liver that someone who would have taken better care of it COULD have had, then I consider that a waste. Yes, I would rather it went to someone who would make the most use out of it.

I'm all up for people having a second chance, but if you mess it up after that one, that would be it. It's already good enough that you were given another opportunity to correct your behaviour, why throw it away? Organs don't grow on trees yet.

Not long ago, a Portuguese football player's son was diagnosed with leukemia. Loads of fans rushed to the hospitals to get tested and see if they were a match so they could help the little boy. It makes me a bit upset that most of them just went there because it was someone famous and forget the rest. How many people need transplants and are neglected because they're not popular?

People who obviously deliberately destroy their bodies by abusing it, or are too spineless to quit the abuse, should be after those who are innocent of their illness and the need of an organ transplant I think. And after my death I could donate my organs, for I don't need them anymore and there are hundrets who could be rescued by getting mine, so why wouldn't I ?

No doubt there is ground for serious injustice and sometimes malpractice in the selection of recipients for donated organs.

There is, also, the same problem in all human activities. The only way, I think, it is possible to have a small percentage of well done work is to manage every case through a responsible and trusted organization (which can also be reached by any of the immoral acts mentioned previously, but it may be controlled to minimize this situation), prepared to set priorities as per a previously established code.

Another moral problem that seems to deserve study is the age of the recipient. Are young people, or babies, to be considered before old people since they have the opportunity to live longer?

Maybe... but who is the person who dare to judge that!

Moreover, with the rapidly increasing of the span of life of humankind, the possibilities to obtain organs in good conditions decrease dramatically.

I do not think age being a factor is a moral dilemma at all, so long it is left as a question of the viability of the transplant, not as a statement on who is more important to society. 90 year olds are a health risk in any surgery. Is that a moral question, NO simply a medical criteria like all the others.

Untony. I agree with you. Maybe there should be a completely trusted, independant organisation who can set the boundaries so to speak (although corruption can creep into anything).

Excellent points about the ages of the recipients / life-span of humankind. I guess at the moment it is the specialists who make those decisions and as I've said before, it must be a very very hard thing for them to do.

I get your point though. I think people who just happened to find themselves in such a terrible situation should be given a chance to get the organ before people that might go back to the act like George. But life hasn't been fair though.Nice read.

I see your point, but in my opinion, everyone deserves equal treatment. A human life is important, everyone is somebody's child etc. By your logic, we're determining human value based on one action, abuse of one's own body via addiction to a vice. What you tend to ignore is that these people may also be donating large amounts to charity, or perhaps getting married on tuesday, or maybe even having 7 kids to take care of.

There are way too many outside factors to say that one person deserves a life before someone else point blank, and doing so would pose for a very closed minded statement (IMO again). By that logic, we should let people with contagious diseases die out, because that way we won't have to worry about them going around any more. Many can be quick to judge as long as it isn't them on the operating table. Gotta have all that empathy and whatnot.

An interesting contribution to the discussion. Does it then matter how much someone donates to charities? Should this give them free reign to abuse their bodies and then go up the list for organ donation? I do understand your point but I'm undecided if I agree or not. Personally, if I abuse my own body then I wouldn't feel entitled to a replacement organ as a matter of right over others who had taken better care of themselves. Thanks Anonymous for your participation here.

In the U.S. (in the state of Georgia) the DMV offered a discount on getting a drivers license if you agreed to be an organ donor. I don't know when or why they stopped doing that. I am sure there were a lot more donors then. I am still a donor even though I don't get that discount anymore. They also offer a way for you to "bank" your child's cord blood after they are born. It is incredibly expensive. Nothing I could fit in my budget. I couldn't put it in my own personal cord blood bank vault so I donated it. If my child ever needs it, maybe it will still be available. If not, oh well. I did my part in possibly saving the life of another child somewhere. I am a recovering addict - I am lucky there is no evidence of liver damage. BUT, I have been in recovery for over a year now. I hope to have many more. God-willing, there will be no more relapses. Here's my question. Does my past drug abuse kick me out of the running for transplant if it is ever needed? Should it? Why or why not? Why is my life worth more or less than the teenager with a heart defect or liver problems? All life is precious, in my opinion.

The discount scheme you mentioned to be an organ donor is a good idea in my opinion, it's a win win situation. You get a discount and someone has an opportunity to have an organ transplant.

In one of my comments above I mentioned that if I was personally abusing my body then I wouldn't feel entitled to a replacement transplant, because my own thoughts suggest that I am taking the place of someone who was doing all the right things. So I personally would feel very guilty to do this. In my post I also mentioned about seeing people who are very ill in hospital but yet they were smoking away in the midst of getting medical treatment. What use would a healthy lung be if it was given to someone who was, without question going to abuse it again. Wouldn't it be better if it were given to someone who was going to take good care of it. Thanks for you comment Nattie.

I agree that someone who is still abusing their organs should be put on the bottom of the list for the organ in question. The things I have put into my body could have caused a lot of damage and I am grateful that it didn't. I have seen people who did the same things as me, in smaller amounts, and suffer worse fates.

I believe every person on the planet as an equal right to life. I also believe that we have an expiry date. This is how the natural order of things its maintained.Artificially giving an infant, born with damaged or missing organs, a few years of life, or allowing adults to escape the consequences of a life's worth of decisions is, in my opinion, wrong.I would like to see humankind invest as much money and resources in protecting and enhancing the natural environment of our planet as they do in protecting what is probably the greatest threat to it.I would also like to see people made more responsible for their life decisions. Smokers should not be treated for smoking related illnesses using funds from the National Health Service likewise morbidly obese people who continue to eat ridiculous amounts of sugary or fatty foods should have to fund their own recovery.We live in a world of limited resources, a world which we share with countless other species. We should act as guardians of that world, rather than the virus that kills it. In conclusion I should state that I would neither use nor donate organs.

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The aim of Rum-Punch is to stimulate discussion, straight talking and the free flow of ideas - just like the drink :)
Its also to provoke thought, and provide a forum for people to give suggestions to others. A good thought can change a bad idea.
I aim to post an article every 2 weeks.